Sample Record

Owner Lab

  • CT D02 - North Region Materials Lab

DIME Sample ID 2021-10-14-39

Project Information

Project IdentifiersProject ID: 215403
DEA: 021H4004
EFIS: 0216000042
DIST-CO-RTE-PM02-SIS-5-R8.3
Award Date03/02/2021
Closeout DateNot set
Work DescriptionPLACE STRUCTURAL CONCRETE BRIDGE DECK AND BARRIER AND PLACE HMA.
Location DescriptionSISKIYOU COUNTY NEAR MOUNT SHASTA AT AZALEA ROAD OVERCROSSING
QA Service Level1 (Verified on 01/07/2021)

Sample Information

Sample Taken Date10/14/2021 Sample Unique Key39
Will the laboratory/organization for which you are a member perform testing on this material sample?Yes Date that the sample was received by the laboratory/organization performing the testing10/14/2021
Sample typeAcceptance A brief description of the sampleCombined 3/4 Inch treated coldfeed and 3/8 Inch RAP
The quantity of what the sample constitutesCombined Coldfeed and RAP for PSE From where was the sample collectedManufacturer
First name of sampler or witnessed byUnknown Last name of sampler or witnessed byUnknown
Title of samplerUnknown Telephone number of sampler
Laboratory sample identificationD78959 Linked DIME Sample ID2021-10-14-37, 2021-10-14-38
The fabricator/manufacturer/facility nameJ F Shea Construction Inc - Fawndale Rock and Asphalt - Redding CA Transportation Laboratory (TL) Number853084
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAggregate Source Identification (SMARA or name of Pit)91-45-0017
The fabricator's/manufacturer's product name for the sampleUnknown The fabricator/manufacturer designation for the sampleUnknown
The plant numberUnknown A detailed description of where the material sample was collectedBelt
Where the material sample would have been placed if not sampled02 SIS 5 Primary Aggregate Nominal Size3/4 inch
The concrete mix design number Lot numberUnknown
Sublot numberUnknown HMA Design ID

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2021-10-14-39-1AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)Colt SweenyCT D02 - North Region Materials Lab10/19/2021Darrell Valasek
No
Info